BACKGROUNDAt approximately 0845 hours Eastern Daylight Time on Tuesday, September 11, a commercial airplane crashed into the north tower of the World Trade Center complex in New York City. At that time, the severity of the incident, the numbers of people involved, and the reason for the crash were all unknown. Shortly after 0900 hours, a second plane hit the south tower of the World Trade Center.Around 1000 hours, reports came in that another commercial plane hit the Pentagon, in Washington, DC, and a fourth commercial plane was downed in Somerset County, PA, about 80 miles southeast of Pittsburgh.Shortly after 1000 hours the south tower of the World Center collapsed. Within the next half-hour, the northern tower of the World Trade Center also collapsed.At approximately 1730 hours a third tower in the World Trade Center complex, Building #7, also collapsed.Wednesday evening, September 12, another building within the World Trade Center Complex collapsed. No additional casualties are expected due to this. However, it may make recovery more difficult.In New York City the Department of Health has determined that there has not been any damage to any New York City hospital.1PERSONNELNew York CityThere has been no change reported from the NYC MST.There are three Management Support Teams (MSTs) established in the New York City region. The main MST is at LaGuardia, it is supported by satellite MSTs at Chelsea Pier and Stewart ANGB.DMATThere continues to be five Disaster Medical Assistance Teams (DMATs) on site in the New York City area. Personnel from DMATs have been deployed to downtown New York City: one at Chelsea Pier, and one at Borough Municipal Community College.As of 1600 hours today, there are currently 525 personnel deployed to the NYC area in support of the operational response. 104 have been deployed to operational sites within NYC (36 to LaGuardia (LGA); 20 to College; 31 to Chelsea; 7 to the Armory; 6 VMAT; and 2 to the Medical Examiner’s office).There are 162 currently staged in New York City at the LGA Marriott. And there are 252 currently staged at Stewart ANGB.In addition, DMAT has establish a forward treatment area about 1 block from the World Trade Center.A total of ten burn nurses have been deployed to provide staffing relief for 32 critical patients at the NY Burn Center.DMORTThe Disaster Portable Morgue Unit (DPMU) has been set up at the LaGuardia airport. A plan is currently being establishing for staffing of the DPMU.Disaster Mortuary Operational Response Team (DMORT) personnel are deployed to the City Medical Examiner’s Office, to the Family Assistance Center at the Armory, and to LaGuardia airport. The temporary morgue at Hanger 7 is operational but has not yet received any remains.Forty-four DMORT personnel are currently providing 24-hour support to the city Medical Examiner. Their duties are: 6 data entry, 10 morgue clean-up, 3 photo/scanning, 2 supervisors, and 2 liaison officers, for a total of 22 personnel per shift. Operations are currently described as “slow”. Operations at the Medical Examiner’s office are expected to increase.Fifteen DMORT personnel are currently involved providing support from 0800 to 2000 daily at the Family Assistance Center located at 68 Lexington Avenue (24th & Lexington). DMORT personnel are currently conducting limited family interviews, collecting records, and answering phones.2The Medical Examiner’s office requested personnel and supplies to support the collection of DNA from family members of the World Trade Center victims. DNA collection will take place at the 7th Regiment Armory at 62 Park Avenue, Room 107. They have requested 14 personnel (6 nurses, 1 nursing supervisor) to two 12-hour shifts. Supplies requested and received include:Individually wrapped Q-tips 12,000White #10 Envelopes 12,000Brown Lunch Bags 40,000Modeling ClayDMORT family assistance personnel are on site at the ACS Building; 29 1st Street in New York.USNS ComfortThe 250-bed USNS Comfort, arrived at Pier 92 late yesterday afternoon, September 14. It is currently being used as a DMAT and DMORT personnel rest facility.The tasking for the Comfort remains the same. The desire of the City was reconfirmed to the Joint Chiefs of Staff as of September 13.USNS Comfort security: the United States Coast Guard will provide security for the USNS Comfort in the harbor; the United States Marine Corps will provide security on-board; New York City local law enforcement will provide security on the pier.Unless helicopters are deck-qualified, they will have to land on the pier and patients transported by ground from pier to USNS Comfort.The Commissioned Corps Readiness Force (CCRF) has provided for back-fill for the Navy Medical hospital, in Bethesda, MD, for medical staff that have been deployed to New York City. The backfill includes 26 nurses and nine physicians and 1 pharmacist. In addition, the CCRF has on stand-by: four mental health specialists, three pharmacists to support National Pharmaceutical Stockpile Tactical Advisory Response Unit, and four pharmacists to backfill National Naval Medical Center.VMATVeterinary Medical Assistance Team-1 (VMAT-1), staffed by nine trained veterinary personnel, is operating at the recovery site. They are tending to the cadaveric locating dogs on site assisting with the search and recovery mission. There are approximately 40 dogs on site.VMAT personnel have been requested to provide veterinary support to rescue animals at two incidents. In addition, VMAT personnel have provided foot and leg treatments to rescue dogs. Also, dogs have been treated for eye problems and have been decontaminated after coming off the rubble pile.34NMRT-EThe National Medical Response Team-Weapons of Mass Destruction- EAST (NMRT-E) has arrived at Stewart ANGB. This team is a specialized response force sponsored by the U.S. Public Health Service that is designed to provide medical care following a nuclear, biological, and/or chemical incident. They are specially trained to work towards decontamination of sites, and can provide medical care in contaminated areas if needed.Mental HealthBrian Flynn, Director of the Substance Abuse and Mental Health Services Administration (SAMHSA), is assessing the requirements for mental health support in NYC. Two mental health personnel are deployed to provide consultative services to the City of New York in order to better coordinate local mental health resources.The Surgeon General’s office has identified personnel qualified and able to tend to mental health needs, if requested.PennsylvaniaThere has been no change since SITREP 6.At 0815 Thursday, September 13, after receiving authorization from Secretary Thompson, Gary Moore discussed an interagency agreement with the FBI for DMORT deployment to the Pennsylvania plane crash site. Within hours, the temporary morgue and DMORT personnel were en route. This is the first time that a DMORT will be assisting in this capacity with an FBI investigation.There are four family assistance personnel deployed to the Pennsylvania crash site. They are conducting anti-mortem interviews and briefings with families of the victims.The temporary morgue unit from Kenyon, Texas, is on location at the Friedens Armory in Somerset County, PA. A Management Support Team (MST) of 13 people is on location in Pennsylvania and is operating a command center. DMORT Region III with 35 members has been redeployed from Washington, DC, to Pennsylvania, and is receiving and processing remains.Washington, DCThere has been no change since SITREP 6.In Washington, DC, we are not anticipating a mission request from FEMA. The Pentagon has indicated, as of approximately 1300 ET September 12, that it will administer to all medical and mortuary needs arising from the disaster on its grounds.The National Disaster Medical System is a program of the US Dept. of Health and Human Services, Office of Emergency Preparedness, RADM Robert Knouss, M.D., Director. Telephone 1-301-443-1167.Situation Reports (SITREPs) are available from the NDMS website http://ndms.dhhs.gov